Tuesday, July 14, 2015

A partial answer - at least

Iron Deficiency Anemia.

That's what my doctor told me on the phone yesterday after looking at my lab results.  I had told him in the office on Friday that I thought there was no chance that I had anemia, because my hemoglobin levels were on the high end of normal before I gave blood last time.

As soon as he told me what was causing my symptoms, I wanted to know why, and here the conversation turned somber.  Iron Deficiency Anemia in men is rare and it is usually associated with internal bleeding.  That internal bleeding is often caused by serious upper or lower GI issues, including gastric cancers and colon cancer, along with ulcers and lesions and other less severe causes.  But, it's rare in men - about 2% of the population.  My doctor told me I needed a colonoscopy very soon.

I mentioned to my doctor that I had done a double red blood cell donation in late April (4/21), and asked if it was possibly related to what is going on.  I told him that I haven't had one good workout since I donated blood, and the other symptoms started to show up about 2 weeks later.

He said that I should have been able to recover from the donation, but with all the stress in my life, and trying to push hard at the gym, maybe my body just couldn't recover.  So, he told me to hold off on the colonoscopy.  I told him that I'd prefer to get it done anyway, and I'd schedule it on my own.  While it's entirely possible that the blood cell donation triggered this, it still seems unlikely that I'm the one exception to the rule about the cause of iron deficiency anemia in men.  So, it seems smart to get the colonoscopy done.  If that is clean, maybe I'll need an upper GI too.

So, I'm taking an iron supplement.  I should be able to work out within a week or two if things go well.  If I don't get better, that's another sign that there is some internal bleeding occurring somewhere.

The other thing that alarmed the doctor was a high C-Reactive Protein result.  This test should have a result less than 1.  I've heard of ultra-runners having levels over 20,000 after a 100 miler, leading doctors to think they'd had a heart attack.

CRP is a measure of inflammation in the body, but it's non-specific.  It doesn't tell you where the problem is.  At levels above 3, it is associated with higher cardiovascular health risks.  My value was 13.

So, I'm going to take iron for 2 weeks.  Retest iron levels, hemoglobin levels, reticulocyte count, and CRP, along with a complete blood count.

If the numbers all improve, we might have found the solution.  If not, there's more digging to be done.  But, I think it's important here to not just treat the problem, but to also find the underlying cause of what's going on.

I'm scheduled to do another double red cell donation on 8/11.  My doctor suggested I cancel.  He said my hemoglobin is so low that they wouldn't take my blood anyway.

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